scholarly journals Evolution of Acinetobacter baumannii infections and antimicrobial resistance. A review

2019 ◽  
Vol 2 (1) ◽  
pp. 28-36
Author(s):  
Sonia Elena Popovici ◽  
Ovidiu Horea Bedreag ◽  
Dorel Sandesc
Keyword(s):  
Antimicrobial Agents ◽  
Resistance Mechanisms ◽  
Hospital Environment ◽  
Medical Community ◽  
Molecular Testing ◽  
Medical Systems ◽  
Antimicrobial Drugs ◽  
Hospital Acquired Infections ◽  
Acinetobacter Spp ◽  
Hospital Acquired

AbstractThe emergence of multi-drug resistantAcinetobacter sppinvolved in hospital-acquired infections, once considered an easily treatable pathogen, is troublesome and an immense burden for the modern medical systems worldwide. In the last 20 years the medical community recorded an increase in the incidence and severity of these infections as therapeutic means tend to be less and less effective on these strains. The ability of these bacteria to rapidly develop resistance to antimicrobial agents by continuously changing and adapting their mechanisms, their ability to survive for long periods of time in the hospital environment and the multitude of transmission possibilities raises serious issues regarding the management of these complex infections. The future lies in developing new and targeted methods for the early diagnosis ofA. baumannii, as well as in the judicious use of antimicrobial drugs. This review details the evolution of the pathogenicity of this microorganism, together with the changes that appeared in resistance mechanisms and the advancements in molecular testing for the early detection of infection.

scholarly journals 687. In vitro Activity of a New Generation Oxopyrazole Antibiotic Against Acinetobacter spp.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S312-S312
Author(s):  
Joel Goldberg ◽  
Christopher Bethel ◽  
Andrea M Hujer ◽  
Kristine Hujer ◽  
Steven Marshall ◽  
...  
Keyword(s):  
In Vitro Activity ◽  
Penicillin Binding Proteins ◽  
Hospital Acquired Infections ◽  
New Class ◽  
Carbapenem Resistant ◽  
Acinetobacter Spp ◽  
Gram Negative Organisms ◽  
New Generation ◽  
Hospital Acquired

Abstract Background Acinetobacter spp. resistant to common antibiotics have become a worrying cause of hospital-acquired infections and represent a critical need for innovative antibacterial development. New oxopyrazole agents targeting penicillin-binding proteins (PBPs) based on a non-β-lactam core and incorporating a siderophore moiety (figure) which facilitates transport to the periplasm are being developed which show promise against Gram-negative organisms including Acinetobacter spp. Methods YU253911, an example of this new class of antibacterials, was characterized in vitro. Minimum inhibitory concentrations (MICs) were determined by broth microdilution against a collection of 200 previously described (whole-genome sequencing) Acinetobacter isolates including 98 carbapenem-resistant A. baumannii strains. YU253911’s antimicrobial activity was also evaluated in combination with complementary PBP agents and β-lactamase inhibitors by MIC and disc diffusion testing. All studies were performed according to current Clinical and Laboratory Standards Institute (CLSI) guidelines using iron-depleted media. Breakpoints for ceftazidime were arbitrarily chosen as reference. Results Using ceftazidime (breakpoint ≤8 μg/mL) as a comparator, 175 of the 200 Acinetobacter isolates were susceptible to YU253911, which possessed an MIC50 of 0.5 μg/mL and an MIC90 of 16 μg/mL. This compared favorably to all previously tested β-lactams including penicillins, cephalosporins, monobactams and carbapenems (MIC50s 2 to >16 μg/mL). Against the subset of carbapenem-resistant A. baumannii isolates, YU253911’s potency was similar with an MIC50 of 1 μg/mL. Genetic analysis showed β-lactamase genes, including OXA-23 and other carbapenemases, were common in both YU253911-resistant and susceptible strains. Conclusion YU253911 demonstrates promising in vitro potency against a collection of Acinetobacter isolates and compares favorably to β-lactam antibiotics. Understanding interactions with PBP agents and β lactamase inhibitors is being explored as well as further studies on the mechanism of resistance. Disclosures All authors: No reported disclosures.

Plasmids and Bacterial Strains Mediating Multidrug-Resistant Hospital-Acquired Infections Are Coresidents of the Hospital Environment

2013 ◽  
Vol 19 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Thu Betteridge ◽  
John Merlino ◽  
Jonathon Natoli ◽  
Elaine Y.-L. Cheong ◽  
Thomas Gottlieb ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Hospital Environment ◽  
Bacterial Strains ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

scholarly journals Knowledge, Attitude and Practice of nursing students on Hospital Acquired Infections in Western region of Nepal

2016 ◽  
Vol 12 (3) ◽  
pp. 103-107 ◽  
Author(s):  
Ishwari Sharama Paudel ◽  
Vivek Ghosh ◽  
Purushottam Adhikari
Keyword(s):  
Nursing Students ◽  
Hand Hygiene ◽  
Hospital Environment ◽  
Good Knowledge ◽  
Healthcare Team ◽  
Western Region ◽  
Hospital Acquired Infections ◽  
Attitude And Practice ◽  
Hospital Acquired ◽  
Knowledge Attitude And Practice

Background & Objectives: Hospital-acquired infections (HAIs) are a common problem and challenge faced by hospitals in all countries around the world. Nurses are an important part of the healthcare team that plays a unique role in the control of HAIs. Compliance on the part of healthcare workers (HCWs) including nurses with standard precautions has been recognized as being an efficient means to prevent and control HAIs. The present study was conducted with objective of understanding the level of Knowledge, attitude and practice (KAP) regarding HAIs among nursing students in the Western Region of Nepal.Materials & Methods: This descriptive cross-sectional study was conducted among nursing students posted in different wards of two hospitals of Pokhara. A self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used for data collection.Results: Among the total participants in the study 97% of the participants considered that prevention of HAIs were a valuable part of nurses’ role but only 89% had received formal training regarding hand hygiene. The results show that 74% of the participants had good knowledge regarding HAIs. 82% of the participants felt that they would be less likely to transmit infection to the patient if they performed hand-hygiene. 66% of them identified that hand hygiene agents were not readily available in current settings. Regarding practice, only 6% performed hand hygiene before patient contact.Conclusion: The nursing students had good knowledge regarding HAIs that was reflected in their attitude and practice on hand hygiene for the prevention of HAIs. However there is the need of regular training and performance feedback regarding hand hygiene and the hospital environment should be hand-hygiene friendly with easily accessible to sinks and other facilities.

scholarly journals Clostridium difficile Infections: A Global Overview of Drug Sensitivity and Resistance Mechanisms

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Saeed S. Banawas
Keyword(s):  
Clostridium Difficile ◽  
Drug Sensitivity ◽  
Antimicrobial Agents ◽  
Treatment Options ◽  
Resistance Mechanisms ◽  
Antimicrobial Drugs ◽  
The Past ◽  
Target Sites ◽  
Resistance Patterns ◽  
Healthcare Associated

Clostridium difficile (C. difficile) is the most prevalent causative pathogen of healthcare-associated diarrhea. Notably, over the past 10 years, the number of Clostridium difficile outbreaks has increased with the rate of morbidity and mortality. The occurrence and spread of C. difficile strains that are resistant to multiple antimicrobial drugs complicate prevention as well as potential treatment options. Most C. difficile isolates are still susceptible to metronidazole and vancomycin. Incidences of C. difficile resistance to other antimicrobial drugs have also been reported. Most of the antibiotics correlated with C. difficile infection (CDI), such as ampicillin, amoxicillin, cephalosporins, clindamycin, and fluoroquinolones, continue to be associated with the highest risk for CDI. Still, the detailed mechanism of resistance to metronidazole or vancomycin is not clear. Alternation in the target sites of the antibiotics is the main mechanism of erythromycin, fluoroquinolone, and rifamycin resistance in C. difficile. In this review, different antimicrobial agents are discussed and C. difficile resistance patterns and their mechanism of survival are summarized.

scholarly journals Cinnamomum verum (True Cinnamon) Leaf Essential Oil as an Effective Therapeutic Alternative against Oral and Non-oral Biofilm Infections: A Brief Review

2020 ◽  
Vol 3 (3) ◽  
pp. 556
Author(s):  
Gayan Kanchana Wijesinghe ◽  
Thaís Rossini de Oliveira ◽  
Flavia Camila Maia ◽  
Simone Busato de Feiria ◽  
Felipe Joia ◽  
...  
Keyword(s):  
Essential Oil ◽  
Antimicrobial Agents ◽  
Communicable Disease ◽  
Resistance Mechanisms ◽  
Therapeutic Agents ◽  
Antimicrobial Drugs ◽  
Hepatic Diseases ◽  
Microbial Infections ◽  
Leaf Essential Oil ◽  
Biofilm Structure

Medicinal plants play a major role as an alternative therapeutic agents for various disease conditions including cardiac and hepatic diseases, microbial infections and non-communicable disease such as diabetes mellitus. With the excessive use of synthetic antimicrobial drugs, micro-organisms become more virulent and resistant to available antimicrobial therapeutic agents. Further majority (around 60%-80%) of human microbial infections are biofilm associated infections and various resistance mechanisms of biofilms make it more difficult to eradicate or treat biofilm infections using available antimicrobial therapeutics. Further, biofilm structure acts as a physical barrier and prevent penetration of antimicrobial agents towards the biofilm core. Currently, scientists pay their attention to invent novel effective antimicrobial agents with less side effects for these biofilm infections. Phytochemicals have identified as a potential alternative antimicrobial strategy in biofilm control and eradication. Cinnamomum verum is a native Sri Lankan medicinal plant that has been widely used as a culinary spice, exhibits many medicinal benefits especially activity against microbial infectious diseases. Essential oils extracted from leaf and bark of C. verum have been used as a safe and effective antimicrobial agents against various infections for centuries. This review analyses the available scientific literature evidences on appositeness of true cinnamon leaf essential oil as an alternative antimicrobial strategy to control microbial biofilm infections with medical importance.

scholarly journals Physical Plant Design and Engineering Controls to Reduce Hospital-Acquired Infections

2006 ◽  
Vol 17 (3) ◽  
pp. 151-153
Author(s):  
JM Conly ◽  
BL Johnston
Keyword(s):  
Patient Safety ◽  
Disease Transmission ◽  
Hospital Setting ◽  
Hospital Environment ◽  
Robert Wood Johnson Foundation ◽  
Plant Design ◽  
Design Standards ◽  
Hospital Acquired Infections ◽  
Physical Plant ◽  
Hospital Acquired

The importance of the environment as a reservoir for microorganisms implicated in disease transmission in the hospital setting has been increasingly recognized, especially with respect to dialysis units, ventilation in specialized areas, and the proper use of disinfectants (1). Inherent within the environmental setting is the importance of physical plant design. Several studies have underscored the importance of optimizing design standards to maximize patient and health care worker (HCW) safety, including the prevention of hospital-acquired infections in patients (2-6). Ulrich et al (7) recently completed an evidence-based review, entitled'The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime opportunity', for the Center for Health Design in California (USA), which was funded by the Robert Wood Johnson Foundation. Ulrich and colleagues identified over 600 studies that examined the hospital environment and its effects on staff effectiveness, patient safety, patient and family stress, quality and costs. They suggested that one of the important elements in improving patient safety is the reduction of the risk of hospital-acquired infections through improved facility design.

Antibiotic Cycling and Marketing Into the 21st Century: A Perspective From the Pharmaceutical Industry

2000 ◽  
Vol 21 (S1) ◽  
pp. S32-S35 ◽  
Author(s):  
Bruce S. Lavin
Keyword(s):  
Antimicrobial Resistance ◽  
Pharmaceutical Industry ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Resistance Mechanisms ◽  
Medical Community ◽  
Resistant Bacteria ◽  
Environmental Pressures ◽  
Development Of Resistance ◽  
Antibiotic Cycling

AbstractBefore the development of the first antimicrobial agents, bacteria already had demonstrated an ability to adapt to stress in the environment, resulting in the development of resistance that often makes the prevailing antibiotic treatment ineffective. The response to antimicrobial resistance in the medical community has been to use new or alternative antibiotics not previously used against the resistant bacteria. The pharmaceutical industry has responded to the resistance problem by producing newer antibiotics, either as modifications of currently existing compounds or as combinations of compounds that may inhibit or bypass the bacterial resistance mechanisms. The development of new antibiotics is a lengthy and costly process. To be successful, the pharmaceutical industry must anticipate the changing needs of the medical community, as well as the dynamic process of antimicrobial resistance. The marketing of new antimicrobial agents must be adaptable to the potential environmental pressures that induce bacterial resistance in order to ensure the longevity of the agents.

scholarly journals The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1146
Author(s):  
Aleksa Despotovic ◽  
Branko Milosevic ◽  
Andja Cirkovic ◽  
Ankica Vujovic ◽  
Ksenija Cucanic ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Concern ◽  
Positive Trend ◽  
Hospital Acquired Infections ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Resistance Rates ◽  
Hospital Acquired ◽  
The Impact

Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU at the Hospital for Infectious and Tropical Diseases, Belgrade, Serbia to assess causative agents of HAIs and AMR rates, with the COVID-19 pandemic ensuing halfway through the study. Resistance rates >80% were observed for the majority of tested antimicrobials. In COVID-19 patients, Acinetobacter spp. was the dominant cause of HAIs and more frequently isolated than in non-COVID-19 patients. (67 vs. 18, p = 0.001). Also, resistance was higher for imipenem (56.8% vs. 24.5%, p < 0.001), meropenem (61.1% vs. 24.3%, p < 0.001) and ciprofloxacin (59.5% vs. 36.9%, p = 0.04). AMR rates were aggregated with findings from our previous study to identify resistance trends and establish empiric treatment recommendations. The increased presence of Acinetobacter spp. and a positive trend in Klebsiella spp. resistance to fluoroquinolones (R2 = 0.980, p = 0.01) and carbapenems (R2 = 0.963, p = 0.02) could have contributed to alarming resistance rates across bloodstream infections (BSIs), pneumonia (PN), and urinary tract infections (UTIs). Exceptions were vancomycin (16.0%) and linezolid (2.6%) in BSIs; tigecycline (14.3%) and colistin (0%) in PNs; and colistin (12.0%) and linezolid (0%) in UTIs. COVID-19 has changed the landscape of HAIs in our ICUs. Approval of new drugs and rigorous surveillance is urgently needed.

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